Provider Demographics
NPI:1497860324
Name:WEST, MICHAEL E (RPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:WEST
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N ELMORE ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:MONTEREY
Mailing Address - State:TN
Mailing Address - Zip Code:38574-1260
Mailing Address - Country:US
Mailing Address - Phone:931-839-7005
Mailing Address - Fax:931-839-7507
Practice Address - Street 1:201 N ELMORE ST
Practice Address - Street 2:SUITE F
Practice Address - City:MONTEREY
Practice Address - State:TN
Practice Address - Zip Code:38574-1260
Practice Address - Country:US
Practice Address - Phone:931-839-7005
Practice Address - Fax:931-839-7507
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4290260001Medicare NSC